Lekhjung Thapa1, Shakti Shrestha2, Rashmi Kandu3, Mahesh Raj Ghimire4, Sulochana Ghimire5, Navin Kumar Chaudhary6, Bishnu Pahari7, Suman Bhattarai1, Ghanshyam Kharel8, Raju Paudel1, Pankaj Jalan9, Avinash Chandra10, Subash Phuyal11, Bhojraj Adhikari12, Nirmal Aryal13, Om P Kurmi14. 1. National Neuro Centre, Kathmandu, Nepal. 2. Research Unit, Neuro and Allied Clinic, Bhairahawa, Nepal; School of Pharmacy, The University of Queensland, Queensland, Australia. Electronic address: shakti.shrestha@uq.edu.au. 3. Department of Nursing, Neuro and Allied Clinic, Bhairahawa, Nepal. 4. Department of Internal Medicine, Devdaha Medical College and Research Centre, Devdaha, Nepal. 5. Department of Nursing, Universal College of Medical Sciences, Bhairahawa, Nepal. 6. Department of Microbiology, Chitwan Medical College, Bharatpur, Nepal. 7. Department of Nephrology and Transplant Medicine, Grande International Hospital, Kathmandu, Nepal. 8. Department of Neurology, Tribhuvan University Institute of Medicine, Kathmandu, Nepal. 9. Department of Neurology, Norvic Hospital, Kathmandu, Nepal. 10. Department of Neurology, Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. 11. Department of Radiology and Interventions, Grande International Hospital, Kathmandu, Nepal. 12. Department of Medicine, Bharatpur District Hospital, Kathmandu, Nepal. 13. Faculty of Health and Social Sciences, Bournemouth University, United Kingdom. 14. Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada; Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom.
Abstract
BACKGROUND: Stroke related studies in Nepal are primarily hospital-based and mainly from the capital city. OBJECTIVES: We aimed to estimate the prevalence of stroke and stroke risk factors in the South-Western community of Nepal. METHODS: A cross-sectional study was conducted from May to August 2018 among 549 randomly selected Nepalese participants from diverse ethnicity, aged ≥15 years, in a region with the availability of neurological support facilities. Data were collected using a stroke questionnaire designed for the purpose. Stroke was identified by enumerators using the Balance-Eyes-Face-Arms-Speech-Time (BEFAST) scale, and a senior neurologist confirmed it. We assessed the presence of major risk factors associated with stroke. RESULTS: The crude and age-standardised prevalence of stroke were 2368 and 2967 per 100,000 respectively. Of all the surveyed participants, 61% (n=335) reported consumption of full-fat dairy products >3 days per week, 87.6% (n=481) reported a high intake of salt (>5 g/day), 83.6% (n=459) with a low intake of fruits and vegetables (<400 g/day), 45.2% (n=248) with perceived stress related to work or home, 51.6% (n=283) with financial stress (283, 51.6%), 86.7% (n=457) with low high-density lipoprotein, 96.2% (n=507) with high blood urea nitrogen, 47.1% (n=356) were either overweight or obese 20.4% (n=112) with hypertension and 6.2% (n=34) with diabetes. CONCLUSIONS: The prevalence of stroke in the community of the South-Western part of Nepal is relatively higher than that estimated in South-Asia and global context. Our findings suggest an urgent community intervention, particularly with healthy lifestyles changes for future stroke prevention in the high-risk group.
BACKGROUND:Stroke related studies in Nepal are primarily hospital-based and mainly from the capital city. OBJECTIVES: We aimed to estimate the prevalence of stroke and stroke risk factors in the South-Western community of Nepal. METHODS: A cross-sectional study was conducted from May to August 2018 among 549 randomly selected Nepalese participants from diverse ethnicity, aged ≥15 years, in a region with the availability of neurological support facilities. Data were collected using a stroke questionnaire designed for the purpose. Stroke was identified by enumerators using the Balance-Eyes-Face-Arms-Speech-Time (BEFAST) scale, and a senior neurologist confirmed it. We assessed the presence of major risk factors associated with stroke. RESULTS: The crude and age-standardised prevalence of stroke were 2368 and 2967 per 100,000 respectively. Of all the surveyed participants, 61% (n=335) reported consumption of full-fat dairy products >3 days per week, 87.6% (n=481) reported a high intake of salt (>5 g/day), 83.6% (n=459) with a low intake of fruits and vegetables (<400 g/day), 45.2% (n=248) with perceived stress related to work or home, 51.6% (n=283) with financial stress (283, 51.6%), 86.7% (n=457) with low high-density lipoprotein, 96.2% (n=507) with high blood ureanitrogen, 47.1% (n=356) were either overweight or obese 20.4% (n=112) with hypertension and 6.2% (n=34) with diabetes. CONCLUSIONS: The prevalence of stroke in the community of the South-Western part of Nepal is relatively higher than that estimated in South-Asia and global context. Our findings suggest an urgent community intervention, particularly with healthy lifestyles changes for future stroke prevention in the high-risk group.